NA JURE 



\_fune 19, 1884 



average number of days' sickness, per member, per annum, is 

 very nearly a week and a half ; and this agrees, generally, with 

 the estimates made in other Societies by Mr. Neison and others. 

 But the averages thus obtained include the cases of members of 

 all ages, and among them many cases of chronic sickness and 

 inability to work during old age. In order, therefore, to get a 

 better idea of the actual annual loss of work through sickness, 

 he has taken the published experience of the members of the 

 large group of Friendly Societies known as the Manchester Unity 

 of Odd Fellows ; and then, on the fair assumption that the rates 

 of sickness of the whole population during the working years of 

 life would not be far different, he has calculated the following 

 tables, showing the average annual rates of sickness of each 

 person, enumerated in the Census of 1SS1, as living between the 

 ages of 15 and 65 : — 



Weeks' Sickness Average 



Number of Males : per annum, accord- Sickness 



^ Census of 1881 ing to the ex- per indi- 



(England and perience of the vidual per 



Wales). Manchester annum (in 



Unity. weeks). 



15-20 ... 1,268,269 •• 844,428 ... -666 



20-25 ••■ i>H2,354 ••• 820,183 ••• 737 



25-45 •■• 3.239,432 ... 3,224,134 ... -995 



45-65 ••• i,755,Si9 ••■ 4,803,760 ... 2736 



All ages from 15-65 



7,375, S74 



9,692,505 ... 1-314 



All ages from 15-65 



7,941,330 ... 10,592,761 



Briefly, it appears from these tables that the average time of 

 sickness among the male population during the working years is 

 a small fraction more than 9 days each in each year — and that 

 among the female population it is yet a small fraction more ; the 

 excess arising from the larger proportion of persons at the later 

 ages. The result is that among males there is a loss of 9,692,505 

 weeks' work in every year, and among females a loss of 10,592,761 

 weeks. Thus we may believe that our whole population between 

 15 and 65 years old do, in each year, 20,000,000 weeks' work 

 less than they might do if it were not for sickness. The estimate is 

 so large that it must, on first thoughts, seem improbable ; but on 

 fair consideration I believe it will not seem so. For the members 

 of the Manchester Unity who are in the working time of life 

 the reckoning is certainly true, and it is founded on the experience 

 of between 300,000 and 400,000 members. In respect of health 

 they may represent the whole population at least as well as any 

 group that could be taken. They are not very strictly selected, 

 they are not picked lives, yet they are such as are able, when 

 they are in health, to earn good wages or good salaries, and, as 

 their prudence in joining this association shows, they are com- 

 paratively thrifty and careful persons. They do not, at all 

 events, include many habitual drunkards, cripples, or utter in- 

 valids, or those who, through natural feebleness or early disease, 

 ■or mere profligacy, cannot earn enough to become members or 

 maintain themselves in membership. Neither do they include 

 many of the insane or imbecile and idiotic, of whom there are, in 

 our population, nearly 70,000 doing no work, and losing not less 

 than 3,500,000 of weeks' work in the year. 



It would be tedious to tell the grounds on which the estimate 

 may be deemed too high, for just as many and as good could be 

 told on which it might be deemed too low. And it is rather more 

 than confirmed by some estimates of the annual sickness in other 

 and very different groups of persons. 



In the Army, at home, the average number of days' sickness in 

 each year is, for each soldier, about 17; and as the number of 

 the troops in the United Kingdom is more than So.ooo, we have 

 hen- a loss of about 200,000 weeks' service in each year. 



In the Navy, on the home stations, the average number of 

 days' sickness in each year has been in the last five years for 

 each man nearly 16 ; so that for the total of about 20,000 men 

 there is a loss of 45,000 weeks' service in each year. 



The amount of sickness in the services thus appears much 



higher than in the Friendly Societies. This is due, in great 

 part, to the fact that a soldier or a sailor is often put off duty 

 for a day or two for much less illness than that for which a 

 civilian would " go on his club." Still, the one estimate may 

 confirm the other ; for the sickness in the Army and Navy is 

 that of picked men, who were selected for the services as being 

 of sound constitution, and who are in what should be the best 

 working years of life : and if it includes many cases of sickness 

 for only a day or two, it excludes nearly all cases of more than 

 a few months, such as make up a heavy proportion of the 

 average sickness in the Friendly Societies and in the general 

 population. 



And I may add that the estimate from these Societies, that 

 9 days in the year may justly be thought a fair estimate of 

 the working time lost by sickness, is confirmed by the records of 

 sickness among the 10,000 members of the Metropolitan Police 

 Force ; for among these, including cases of long illness such as 

 are also in the Societies, the average is more than 9 days in 

 the year. 



I think, then, that we cannot escape from the reasons to 

 believe that we lose in England and Wales, every year, in con- 

 sequence of sickness, 20,000,000 of weeks' work ; or, say, as 

 much work as 20,000,000 of healthy people would do in a week. 



The number is not easily grasped by the mind. It is equal to 

 about one-fortieth part of the work done in the year by the whole 

 population between 15 and 65 years old. Or, try to think of it 

 in money. Rather more than half of it is lost by those whom 

 the Registrar-General names the domestic, the agricultural, and 

 the industrial classes. These are rather more than seven millions 

 and a half in number, and they lose about 11,000,000 of weeks ; 

 say, for easy reckoning, at a pound a week ; and here is a loss 

 of 11,000,000/. sterling from what should be the annual wealth 

 of the country. For the other classes, who are estimated as 

 losing the other 9,000,000 weeks' work, it would be hard and 

 unfair to make a guess at the loss in any known coin ; for these 

 include our great merchants, our judges and lawyers, and medical 

 men, our statesmen and chief legislators ; they include our poets, 

 and writers of all kinds, musicians, painters, and philosophers ; 

 and our Princes, who certainly do more for the wealth and 

 welfare of the country than can be told in money. 



Before I speak of any other losses of work or of wealth due 

 to sickness, permit me, as in parenthesis, to point out to you 

 how very imperfectly their losses are told or even suggested by 

 our bills of mortality. These, on which almost alone we have 

 to rely for knowing the national health — these tell the losses of 

 life ; and more than misery enough they tell of ; but to estimate 

 rightly the misery of sickness and the losses of all but life that 

 are due to it, we need a far more complete record than these 

 can give. 



Take, for example, such a disease as typhoid fever — that 

 which Mr. Huxley has rightly called the scourge and the dis- 

 grace of our country. It has of late destroyed in England and 

 Wales, among persons in the working time of life, nearly 4000 

 in the year. Its mortality is about 15 per cent., so that if in 

 any year 4000 die of it, about 23,000 recover from it. Of these 

 the average length of illness is, on the authority of Dr. Broad- 

 bent, about ten weeks. Mere, therefore, from one disease alone, 

 and that preventible, we have an annual loss of 230,000 weeks' 

 work, without reckoning what is lost with those who die. And 

 the same may be said of nearly all the diseases that are most 

 prominent in the bills of mortality. The record of deaths, sad 

 as it is, tells but a small part of the losses of happiness and 

 welfare that are due to sickness. It is as if, in a great war, we 

 should have a regular return of the numbers killed, but none of 

 the numbers sick and wounded, though these, more than the 

 killed, may determine the issue of the war. 



Let me now tell of another loss of work and of money through 

 sickness and early death. In all the estimates I have yet 

 referred to, no account is taken of those who are ill or die before 

 they are 15 years old. They are not reckoned as in the 

 working-time of life, though in some classes many thousands of 

 them are. [In the domestic, agricultural, and industrial classes 

 of the Registrar-General nearly half a million of them are 

 included.] And yet the losses of work due to sickness among 

 children must he very large. Consider the time which might 

 be spent in good productive work, if it were not spent in taking 

 care of them while they are ill. Consider, too, the number of those 

 who, through disease in childhood, are made more susceptible 

 of disease in later life, or are crippled, or in some way per- 

 manently damaged ; such as those who become deaf in scarlet 



